Responses to the coronavirus outbreak are disrupting all sides of substance abuse treatment in Durham.
Triangle Residential Options for Substance Abusers, Durham’s best known addiction treatment program, has stopped accepting new residents for the first time since it opened in 1994.
Restrictions imposed by government emergency orders forced the non-profit, recently home to 456 people, to shut down two “social enterprises” that help pay for its long-term residential treatment. TROSA’s moving outfit and thrift store are shuttered, businesses that account for $9.5 million, half of its annual revenue, according to its website.
Other substance abuse treatment outfits have also temporarily reduced or ended operations, limiting their ability to help people free themselves from drug and alcohol dependence. Others have found ways to adapt.
Recovery Community of Durham, located in the Hayti Heritage Center, serves many people who are homeless. Normally, it does intensive outreach, offering clients access to technology, counselors, rides to counseling appointments, and referrals for mental health, substance abuse, housing, and employment.
But RCOD has been forced to end most operations, other than walk-in hours. “I would estimate foot traffic has decreased by 80% which has been devastating for us,” said Robert Thomas, chairperson of RCOD’s board of directors.
What’s more, clients are telling staff that they can’t reach programming that helped them in the past, including getting to Narcotics Anonymous meetings, which have all gone online.
“I just talked to a client this morning and she started back using. She said she couldn’t get to no NA meetings because she didn’t know how to do Zoom,” said Michelle McKinney, a peer-support specialist and outreach coordinator at RCOD.
McKinney told the client to go to Durham Recovery Response Center, a short term care center for mental health and substance abuse crises, to seek detox treatment. But RCOD clients who already struggled with transportation, have even less mobility now because RCOD can no longer provide rides.
The Durham Rescue Mission, a Christian shelter, suspended its Victory Program following Gov. Roy Cooper’s March 23 executive order that banned gatherings of more than 50 people, said chief operating officer Rob Tart. The 12-month recovery program usually enrolls 65 to 70 people.
Durham Rescue shut down its thrift store too, which typically generates for approximately 50% of the annual budget, Tart said.
As of Monday, Durham Rescue shelters housed 332 men and 88 women and children and continued to accept new residents, according to Tart. The women’s division is housed in the mission’s Good Samaritan Inn, where staff have sectioned off singles for residents who show signs of coronavirus infection.
Residents have been free to come and go, but upon re-entry, staff take their temperatures, according to Tart. Inside, residents still cook meals, clean dishes, and tidied their surroundings. But now they must also wipe down door knobs and sit only two people at a time at eight-foot round tables.
As of Thursday morning, no residents had tested positive, Tart said.
“We are not able to hold our group meetings or classroom meetings. That has been the biggest hit to the clients,” Tart said. Individual counseling persists in person and over video chat, however. Tart said he fears that some residents may be retreating back to their substances due to the lack of programming the Mission can now offer.
Durham County is normally home to 96 weekly English and Spanish-language AA meetings. Most continue over the video conferencing platform, Zoom, due to COVID-19 and the stay-at-home orders, according to a local AA district committee member, who identifies herself as A.E.
A.E, who uses initials to remain anonymous like AA suggests, said she has been sober for 38 years. She started “going to” meetings every day when Durham’s AA meetings went online. Her home meeting in Durham usually attracted around 60 people; over Zoom, it draws around 80.
Greg, who uses a first name to maintain his anonymity, said he has been to Alcoholics Anonymous meetings in Texas, Connecticut, Vermont, Las Vegas, and Australia while complying with stay-home orders, thanks to Zoom capabilities. Still something is lost.
“There’s still something about being in a room, face to face with another person, an alcoholic,” Greg said.
The pandemic is also bringing disparities that have always existed to the fore. Not all people struggling with substance abuse have access to technology, for instance.
“AA really should be open to anyone, but to participate in an online meeting, especially now that the libraries are closed, requires you to have a smartphone or a computer and the ability to navigate them,” said B.R., a member of a district 32 subcommittee.
Some people are seeking mental health resources from the Recovery Response Center for the first time following job losses due to the pandemic, said Joy Brunson Nsubuga, center director. Staff are particularly concerned about clients they’d just starting working with before coronavirus struck.
“You have to try and keep people on level ground and if that ground was already shaking, it’s shattered for them now,” said Reta Scarlett, another RCOD peer support specialist and outreach coordinator.
Not only are some clients unreachable by phone or email, some can’t be found at all. “I don’t know what is going on with some of these clients, especially the homeless clients. I know they used to be under the bridges, but now they’re not there anymore,” said McKinney.
Working for one of TROSA’s enterprise is a key part of the non-profit’s therapeutic community-based approach to addiction treatment, where people enroll for two years rather than the more common 30-day, 60-day or 90-day schedules.
Those accepted to TROSA, including some who are referred by criminal court judges, gain more privileges and vocational training over time if they remain clean from drugs and alcohol. TROSA residents who worked for the closed operations are being transferred to “non-public facing jobs,” according to a TROSA announcement.
People experienced with addiction treatment note how important it is to have face-to-face support when working towards sobriety. It’s not just the loss of human contact during meetings that threatens people’s sobriety, they say, it’s the isolation that has become a fact of life under stay-at-home orders as well.
“Isolation is one of the most difficult obstacles to serenity and sobriety,” B.R. wrote in an email, adding this “could easily be considered to exacerbate the alcoholic’s typical propensity for isolation.”
Given uncertainty over how long this period of isolation will last, members of the addiction-treatment community could continue to encounter unique hurdles.
At top: Triangle Residential Options for Substance Abusers moving trucks, normally visible on roads across Durham, are parked and locked up. TROSA shut down its moving operations to comply with coronavirus emergency orders. Photo by Corey Pilson